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If heart valve replacement in the 1960s was characterized primarily by the mechanical prosthesis, it would appear that this next decade will see full evaluation of various kinds of tissue valves.
That bellwether of the prostheses, the caged-ball valve, has as its counterpart the homograft valve, usually the aortic valve which has been ingeniously adapted for use also in either atrioventricular ring. Ross and Paneth in England and Barratt-Boyes of New Zealand have wide experience with homograft replacement of the aortic valve, but late calcification and disruption brought into question the techniques of valve sterilization and preservation. Now it seems that the fresh or living homograft may be the valve replacement of choice. Any form of sterilization kills the valve transplant and predisposes to calcific infiltration. The fresh valve is not rejected or is rejected only very slowly, pari passu with healing, because the cusps are so poorly vascularized. The
S. N. Heart Valve Replacement in the 1970s. Arch Surg. 1970;101(1):93. doi:10.1001/archsurg.1970.01340250095024